Appendicitis refers to the inflammation of the vermiform appendix, a vestigial or remnant structure located within the abdomen. Arguably, acute appendicitis remains a leading surgical emergency all over the world, often characterized by excruciating acute abdominal pain that throws the patient into inexplicable agony. If left unattended, the inflamed appendix may rupture leading to complications that could eventually culminate in loss of life. In fact, in 2010, about 35000 deaths globally were attributed to appendicitis. Hence, in most cases, upon confirmation of the diagnosis, surgical removal is promptly carried out.
This article highlights some vital facts you need to know about appendicitis.
1. It is a surgical emergency
Typically, patients suffering from an inflamed appendix present at the emergency ward with such excruciating abdominal pain that warrants urgent assessment. In most cases, the pain is described to have started around the navel (umbilicus) before eventually localizing to the right lower quadrant of the abdomen. The pain is even worse as the attending physician attempts to palpate the abdomen. It is sometimes accompanied by loss of appetite (anorexia), nausea, vomiting and fever. As soon as the diagnosis is established, the best line of action is to prepare the patient for emergency removal of the inflamed appendix (appendectomy)
2. Appendicitis occasionally resolves on its own
In a few instances, it has been discovered that appendicitis either resolves spontaneously or with the administration of broad-spectrum antibiotics without surgery. However, a high rate of recurrence has been recorded in such cases. No wonder the gold standard of treatment remains surgical excision of the appendix.
3. Low fibre intake increases risk
Low fibre dietary intake is an identified risk factor for acute appendicitis such that a higher incidence of this condition has been observed among populations who consume little or no fibre in their diets. This is explained by the fact that low dietary fibre content prolongs the transit time of bowel contents and increases the viscosity of faeces leading to faecal stasis, an important factor in the pathogenesis of appendicitis. In the light of this, you can significantly cut down your risk by consuming more fresh fruits and vegetables as well as other high-fibre diets.
4. Appendicitis often results from obstruction
Research has shown that the majority of cases of acute appendicitis usually follow an obstruction of the appendix lumen by calcified faecal deposits (faecaliths), bezoars, intestinal worms or foreign bodies. The obstructed appendix then becomes filled with mucus and swells. Pressures subsequently build up within the lumen and wall leading to impaired venous drainage and stasis of lymphatic flow. Soon, the appendix tissue becomes necrotic (dead) and bacteria begin to leak out of the dying wall leading to pus formation. The end result is a ‘burst’ appendix that may result in peritonitis, septicaemia and death.
5. Prompt diagnosis is important
The importance of a prompt diagnosis of this condition cannot be overstressed. It’s important to diagnose it early and swing into action before the inflamed appendix ruptures since mortality and morbidity are higher with a ruptured appendix. Aside from the typical migratory abdominal pain with nausea and fever, elevated white blood cell count (leukocytosis) is also highly suggestive. Computed Tomography (CT) scan or ultrasound is useful in confirming the diagnosis.
6. Occurrence varies with age and gender
Studies have shown that the incidence of appendicitis gradually rises from birth, reaches a peak in the late teens and then begins to decline in the elderly whose appendix is believed to have shrunken and very unlikely to get inflamed. Furthermore, appendicitis is most common between the ages of 5 and 40 years and the median age of occurrence is 28 years. Finally, it has also been observed that males carry a slightly higher risk than their female counterparts.
From the foregoing, if you are experiencing pain around your navel or in your lower right abdomen, you may need to visit the hospital for proper evaluation and treatment to exclude sinister conditions like appendicitis.